[Illustration: FIGURE 26.--Reproduction of a Greek vase showing a 5th
century B.C. medical "clinic." Original is in the Louvre. Patient is about
to undergo venesection in the arm. Bronze bleeding bowl catches the blood.
(NMHT 233055 [M-9618]; SI photo 73-4216.)]
[Illustration: FIGURE 27.--Bloodletting man from a New York almanac, 1710.
(From Daniel Leeds, _The American Almanack for the Year of Christian
Account, 1710_. Photo courtesy of the Library of Congress.)]
[Illustration: FIGURE 28.--Phlebotomy manikin in Johannes de Ketham
_Fascicules Medicinae_. Venice, 1495. (From the Dibner Library of the
History of Science and Technology, NMHT.)]
[Illustration: FIGURE 29.--Lionel Wepfer, a 17th century traveler,
described the Indian method of bloodletting as follows: "The patient is
seated on a stone in the river, and one with a small bow shoots little
arrows into the naked body of the patient, up and down, shooting them as
fast as he can and not missing any part. But the arrows are guarded, so
that they penetrate no farther than we commonly thrust our lancets; and if
by chance they hit a vein which is full of wind, and the blood spurts out
a little, they will leap and skip about, shewing many antic gestures, by
way of rejoicing and triumph." (From Lionel Wepfer, _A New Voyage and
Description of the Isthmus of America_, London, 1699. Photo courtesy of
NLM.)]
[Illustration: FIGURE 30.--Flint lancets used by native doctors in
Alaska, 1880s. (Anthropology Catalog 127758; SI photo 73-4208).]
[Illustration: FIGURE 31.--Instruments and technique of phlebotomy: Fig. 1
shows an arm about to be bled. A ligature has been applied to make the
veins swell. The common veins bled--cephalic, basilic, and median--are
illustrated. Fig. 2 shows several types of incisions. Fig. 3 is a fleam,
Fig. 4 a spring lancet, and Fig. 5 a "French lancet." (From Laurence
Heister, _A General System of Surgery_, London, 1759. Photo courtesy of
NLM.)]
[Illustration: FIGURE 32.--Replica of a barber-surgeon's signboard dated
1623. Top left corner shows a phlebotomy being performed. (NMHT 215690
[M-7343]; SI photo 44681.)]
[Illustration: FIGURE 33.--Instruments for bleeding from the arm, 1708: A,
a serviette to cover the patient's clothing; B, a cloth ligature to place
around the arm; C, a lancet case; D, a lancet; E and F, candles to give
light for the operation; G, a baton or staff for the patient to hold; H,
I, and K, basins for collecting blood; L and M, compresses; N, a bandage
to be placed over the compress; P, _eau de la Reine d'Hongrie_ that can be
used instead of vinegar to revive the patient if he faints; Q, a glass of
urine and water for the patient to drink when he revives; R, S, T,
implements for washing the hands and the lancets after the operation.
(From Pierre Dionis, _Cours d'operations de chirurgie demontrees au Jardin
Royal_, Paris, 1708. Photo courtesy of NLM.)]
[Illustration: FIGURE 34.--Two 18th century trade cards advertising
lancets. (Photo courtesy of Wellcome Institute, London.)]
[Illustration: FIGURE 35.--Lithograph, London, 1804, showing a phlebotomy.
(On loan from Armed Forces Institute of Pathology; SI photo 42579.)]
[Illustration: FIGURE 36.--18th-century cutler's illustrations for making
lancets. Note the variations in the shape of the lancet blades. (From Jean
Jacques Perret, _L'Art du Coutelier_, Paris, 1772. Photo courtesy of
NLM.)]
[Illustration: FIGURE 37.--Thumb lancet, 16th century. (From Leonardo
Botallo, _De Curatione per Sanguinis Missionem_, Antwerp, 1583. Photo
courtesy of NLM.)]
[Illustration: FIGURE 38.--Typical 19th-century thumb lancets, engraved
"S. Maw, London." (NMHT 139980 [M-4151]; SI photo 73-4230.)]
[Illustration: FIGURE 39.--Typical 19th-century brass spring lancet and
case. The case is stamped "Traunichtessticht," which translates, "Watch
out, it stabs." (NMHT 308730.10; SI photo 74-4088.)]
[Illustration: FIGURE 40.--Spring lancets, dated 1775. (Held by Rhode
Island Medical Society; SI photo 73-5762.)]
[Illustration: FIGURE 41.--Fleam, 16th century. (From Leonardo Botallo,
_De Curatione per Sanguinis Missionem_, Antwerp, 1583. Photo courtesy of
NLM.)]
[Illustration: FIGURE 42.--Hand-forged fleam with hand-carved wooden case,
17th and 18th century, Swiss or Tyrolean. (NMHT 233570 [M-9666]; SI photo
59139-E.)]
[Illustration: FIGURE 43.--Fleam made by E. Dalman, London. Note unusual
curved shape to blade. (From the original in the Wellcome Museum by
courtesy of the Trustees, photo L. 1346.)]
[Illustration: FIGURE 44.--Silver spring lancet in case. Case is lined
with white silk and rose plush and has a gold leaf border. (NMHT
321687.02; SI photo 76-7752.)]
[Illustration: FIGURE 45.--Unusual spring lancet with extra blade,
engraved "M.A. Prizzi," 18th century. (NMHT 320033.06; SI photo
76-7763.)]
[Illustration: FIGURE 46.--Unusual spring lancet in hand-carved wooden
case, 18th century. Note the large blade and blade guard regulated by a
screw. (NMHT 321.697.12; SI photo 76-9114.)]
[Illustration: FIGURE 47.--George Tiemann & Co.'s spring lancet, late 19th
century. (NMHT 163863 [M-5141]; SI photo 73-5644.)]
[Illustration: FIGURE 48.--Patent model spring lancet, patented by J.W.W.
Gordon in 1857. Back view. (NMHT 89797 [M-4298]; SI photo 73-10319.)]
[Illustration: FIGURE 49.--Patent model spring lancet, patented by J.W.W.
Gordon in 1857. Front view. (NMHT 89797 [M-4298]; SI photo 73-10318.)]
[Illustration: FIGURE 50.--Wet cupping for a headache. (From Frederik
Dekkers, _Exercitationes Practicae Circa Medendi Methodum_, Leyden, 1694.
Photo courtesy of NLM.)]
[Illustration: FIGURE 51.--Dry cupping for sciatica. (From Frederik
Dekkers, _Exercitationes Practicae Circa Medendi Methodum_, Leyden, 1694.
Photo courtesy of NLM.)]
[Illustration: FIGURE 52.--Horn cups used in Egypt in the 16th century.
(From Prosper Alphinus, _Medicina Aegyptorum_, Leyden, 1719. Photo
courtesy of NLM.)]
[Illustration: FIGURE 53.--Horn cup used in the Niger Republic of West
Africa in the 1960s. (NMHT 270023 [M-11998]; SI photo 73-5643.)]
[Illustration: FIGURE 54.--Replica of a Greek votive tablet found in the
remains of the Temple of Aesculapius. Pictured are two metal cups and a
set of scalpels. (NMHT 233055 [M-9617]; SI photo 73-4217.)]
[Illustration: FIGURE 55.--Egyptian spouted cupping cups, 16th century.
(From Prosper Alpinus, _Medicina Aegyptorum_, Leyden, 1719. Photo courtesy
of NLM.)]
[Illustration: FIGURE 56.--Cupping instruments illustrated by Dionis,
1708: A, cups made of horn; B, lamp for exhausting air; C, fleam for
making scarifications; D, horns with holes at the tip for mouth suction;
E, balls of wax to close the holes in the horn cups; F, G, glass cups; H,
candle to light the tow or the small candles; I, tow; K, small candles on
a card which is placed over the scarifications and lit in order to exhaust
the cup; L, lancet for making scarifications; M, scarifications; N,
plaster to place on the wound. (From Pierre Dionis, _Cours d'operations de
chirurgie demontrees au Jardin Royal_, Paris, 1708. Photo courtesy of
NLM.)]
[Illustration: FIGURE 57.--Teapot lamp, 18th century. (NMHT 199536
[M-6691]; SI photo 73-4218.)]
[Illustration: FIGURE 58.--13th-century Arabic cupping scene. (From a
manuscript held by the Freer Gallery. SI photo 43757-J.)]
[Illustration: FIGURE 59.--Pare's scarificator, 16th century. (From _The
Workes of that Famous Chirurgeon, Ambrose Parey_, translated by Thomas
Johnson, London, 1649. Photo courtesy of NLM.)]
[Illustration: FIGURE 60.--Square scarificator, engraved "J.T./Wien," late
18th-early 19th century. Vienna was an early center for the making of
scarificators. (NMHT 218383 [M-9257]; SI photo 73-4212.)]
[Illustration: FIGURE 61.--An early illustration of the scarificator. Also
pictured are a fleam for making scarifications, the pattern of
scarifications, a metal cup, and a leech. (From Laurence Heister, _A
General System of Surgery_, 7th edition, London, 1759. SI photo 73-4182.)]
[Illustration: FIGURE 62.--Square scarificator taken apart. (NMHT 152130
[M-4771]; SI photo 76-9113.)]
[Illustration: FIGURE 63.--Cupping and bleeding instruments, 1780.
Illustrated are spring lancets, thumb lancets, cups, a square scarificator
with pointed blades, and a lamp in which animal fat was burned. Figs. 16,
17, and 18 are unrelated to bloodletting. (From J. A. Brambilla,
_Instrumentarium Chirurgicum Viennense_, Vienna, 1780. Photo courtesy of
NLM.)]
[Illustration: FIGURE 64.--Set of scarificator blades. Each row of
blades may be inserted in place of those in need of cleaning or repair.
(From the original in the Wellcome Museum by courtesy of the Trustees.
Photo L. 2418.)]
[Illustration: FIGURE 65.--An early illustration of the octagonal
scarificator, 1801. This plate also includes one of the earliest
illustrations of the syringe applied to cupping cups. (From Benjamin Bell,
_A System of Surgery_, 7th edition, volume 3, Edinburgh, 1801. SI photo
73-5181.)]
[Illustration: FIGURE 66.--An unusual octagonal scarificator made by
Domenico Pica in 1793. The blade cover is attached by a hinge, and the
turnkey on top raises and lowers the entire interior chassis in order to
regulate depth of cut. (NMHT 320033.01; SI photo 76-7742.)]
[Illustration: FIGURE 67.--Scarificator marked Dom{o} Morett, 1813. (From
the original in the Wellcome Museum, by courtesy of the Trustees. Wellcome
R2909/1936; photo L 1159.)]
[Illustration: FIGURE 68.--Cupping set with base handled torch, 8 blade
scarificator, 4 blade scarificator for cupping on temples, 2 cups and
alcohol bottle. (NMHT, SI photo 76-9119.)]
[Illustration: FIGURE 69.--Calling card, ca. 1860. (SI photo.)]
[Illustration: FIGURE 70.--Cupping set manufactured by Charriere of
Paris, mid-19th century. Note the tubing used to connect the pump to the
cups, and the circular scarificator with blades cutting in opposite
directions. (NMHT 302606.007; SI photo 75-090.)]
[Illustration: FIGURE 71.--W. D. Hooper's patent cupping apparatus with
tubular blades. (From patent specifications, U.S. patent no. 68985. SI
photo 73-5193.)]
[Illustration: FIGURE 72.--Demours' device for combining cup, scarifier
and exhausting apparatus. (From Samuel Bayfield, _A Treatise on Practical
Cupping_, London, 1823. Photo courtesy of the NLM.)]
[Illustration: FIGURE 73.--R. J. Dodd's patent cupping apparatus. Figs. 4
and 5 are the tubes for cupping the uterus. Fig. 3 is the flexible match
scarifier. (From patent specifications, U.S. patent no. 3537. SI photo
73-5192.)]
[Illustration: FIGURE 74.--Circular scarificator. (NMHT 320933.05; SI
photo 76-7746.)]
[Illustration: FIGURE 75.--Scarificator for vaccination. Mallam's, made by
Arnold & Sons, London. Patent 1406. (From the original in the Wellcome
Museum by courtesy of the Trustees. Wellcome 13557; photo 125/1960.)]
[Illustration: FIGURE 76.--Patent model of Tiemann's scarificator. (NMHT
89797 [M-4289]; SI photo 76-9115.)]
[Illustration: FIGURE 77.--Patent model of Leypoldt's scarificator, 1847.
(NMHT 89797 [M-4290]; SI photo 73-4213.)]
[Illustration: FIGURE 78.--Patent model of Leypoldt's scarificator, 1851.
(NMHT 89797 [M-4293]; SI photo 76-9112.)]
[Illustration: FIGURE 79.--Baunscheidt's _Lebenswecker_, a
counter-irritation device. (NMHT 287885 [M-12936]; SI photo 76-7751.)]
[Illustration: FIGURE 80.--Depurator patented by A. F. Jones, 1866. (From
patent specifications, reissue 2276. SI photo.)]
[Illustration: FIGURE 81.--Junod's boot. (On loan from the Armed Forces
Institute of Pathology. SI photo 73-7885.)]
[Illustration: FIGURE 82.--Woman cupping her breast. (From Maw, Son &
Thompson, _Surgeon's Instruments, etc._, London, 1882. SI photo
76-13540.)]
[Illustration: FIGURE 83.--Glass breast pump with spout for self
application. (NMHT 260557 [M-11467]; SI photo 76-7759.)]
[Illustration: FIGURE 84.--Goodyear's patent breast pump, manufactured by
the Union India Rubber Co. (NMHT 252497 [M-10510]; SI photo 76-7762.)]
[Illustration: FIGURE 85.--Brier's Hyperemia Apparatus, 1930s. (From
Matthay Hospital Supply Co., _Surgical Instruments_, Los Angeles, 1937(?).
SI photo.)]
[Illustration: FIGURE 86.--Patent for a complex cupping pump, J. A.
Maxam, 1916. (From patent specifications, U.S. patent 1179129. SI photo
73-5186.)]
[Illustration: FIGURE 87.--Heinrich Stern's phlebostasis chair, 1915.
(From Heinrich Stern, _Theory and Practice of Bloodletting_, New York,
1915. SI photo.)]
[Illustration: FIGURE 88.--Old-fashioned cupping in a German physician's
office, Chicago, Illinois, 1904. (SI photo 45726-B.)]
[Illustration: FIGURE 89.--A man employing leeches to reduce his weight,
16th century. (From P. Boaistuau, _Histoire Podigieuses_, Paris, 1567.
Photo courtesy of NLM.)]
[Illustration: FIGURE 90.--Osborne's instrument for inserting leeches into
the rectum. (From J. Osborne, "Observations on Local Bloodletting,"
_Dublin Journal of Medical and Chemical Science_, volume 3 (1833). Photo
courtesy of NLM.)]
[Illustration: FIGURE 91.--Two leeches (_Hirudo medicinalis_) preserved in
plastic. (Anthropology Catalog no. 143,077; SI photo 73-4233.)]
[Illustration: FIGURE 92.--Satire on the theories of Broussais. The
caption read, "But, I haven't a drop of blood left in my veins! No matter,
another fifty leeches." (Undated print. Photo courtesy of NLM.)]
[Illustration: FIGURE 93.--Woman using leeches, 17th century. (From
Guillaume van den Bossche, _Historica Medica_, Brussels, 1639. Photo
courtesy of NLM.)]
[Illustration: FIGURE 94.--Heurteloup's leech. (From George Tiemann & Co.,
_American Armamentarium Chirurgicum_, New York, 1889. SI photo 76-13541.)]
[Illustration: FIGURE 95.--Tiemann & Co.'s patent artificial leech. (From
George Tiemann & Co., _American Armamentarium Chirurgicum_, New York,
1889. SI photo 76-13541.)]
[Illustration: FIGURE 96.--Reese's uterine leech. (From George Tiemann &
Co., _American Armamentarium Chirurgicum_, New York, 1889. SI photo
76-13539.)]
[Illustration: FIGURE 97.--Sarlandiere's bdellometer. Fig. 13 and Fig. 14
are a teapot lamp and a glass for measuring the blood taken in cupping.
All the other figures illustrate variations on the bdellometer. Fig. 19
and Fig. 20 are attachments for bleeding the internal membranes. (From
Sarlandiere, "Ventouse," _Dictionnaire des sciences medicales_, volume 57,
1821. Photo courtesy of NLM.)]
[Illustration: FIGURE 98.--An artificial leech. Note the three blades on
the scarificator that simulate the triangular puncture of the leech.
(NMHT; SI photo 76-9120.)]
[Illustration: FIGURE 99.--An 18th-century cutler's illustration of
veterinary instruments. Shown are a spring lancet and a fleam. Knives and
hooks were often added to the bloodletting blades in foldout fleams. (From
Jean Jacques Perret, _L'Art du Coutelier_, Paris, 1772. Photo courtesy of
the NLM.)]
[Illustration: FIGURE 100.--Fleam with brass shield, 18th-19th century.
(NMHT 121573 [M-3462]; SI photo 73-4206.)]
[Illustration: FIGURE 101.--Fleam with horn shield, 19th century. (NMHT
321697.05; SI photo 76-7758.)]
[Illustration: FIGURE 102.--Phlebotomy knife by Rodgers & Co., London.
(Loan no. 316478; SI photo 76-9108.)]
[Illustration: FIGURE 103.--Unusual shaped brass spring lancet set by a
sliding catch and released by a release lever. (NMHT 321697.11; SI photo
76-7754.)]
[Illustration: FIGURE 104.--Brass spring lancet that is set by pulling on
the string and released by pushing upon the button. (NMHT 321697.07; SI
photo 76-7750.)]
[Illustration: FIGURE 105.--Spring lancet. (NMHT 112827; SI photo
73-4235.)]
[Illustration: FIGURE 106.--Scarificator, 12 blades. (NMHT 99749 [M-2336];
SI photo 76-7744.)]
[Illustration: FIGURE 107.--Temple scarificator with case. (NMHT 233056
[M-9639]; SI photo 76-7745.)]
[Illustration: FIGURE 108.--Persian cupping glass, 12th century. (NMHT
207389 [M-6836]; SI photo 73-4205.)]
[Illustration: FIGURE 109.--Cupping cups, glass. (NMHT 308730.09; SI photo
74-4087.)]
[Illustration: FIGURE 110.--Persian cupping cup and razor. (NMHT
320033.07; SI photo 76-7749.)]
[Illustration: FIGURE 111.--Brass cup (1) and pewter cups (2). (NMHT
321697.22 and NMHT 207399 [M-6829 and M-6830]; SI photo 76-9109.)]
[Illustration: FIGURE 112.--Cupping set. (NMHT 321697.21; SI photo
76-7747.)]
[Illustration: FIGURE 113.--Breast pump. (NMHT 220170 [M-7435]; SI photo
76-7761.)]
[Illustration: FIGURE 114.--Leech jar, minus top. (NMHT 201821 [M-6712];
SI photo 73-4232.)]
[Illustration: FIGURE 115.--Staffordshire leech jars. (NMHT 321697.18 &
.19; SI photo 76-7765.)]
[Illustration: FIGURE 116.--Leech cage. (NMHT 1977.0576.02; SI photo
77-13984.)]
[Illustration: FIGURE 117.--Veterinary fleam. (NMHT 218383 [M-9255]; SI
photo 61125-A.)]
[Illustration: FIGURE 118.--Veterinary fleam. (NMHT 233570 [M-9665]; SI
photo 59139-H.)]
[Illustration: FIGURE 119.--Veterinary spring lancet. (NMHT 321697.08; SI
photo 76-7756.)]
[Illustration: FIGURE 120.--Veterinary spring lancet. (NMHT 321697.09; SI
photo 76-7755.)]
[Illustration: FIGURE 121.--Spring lancet, 18th century. (NMHT 321697.10;
SI photo 76-7753.)]
[Illustration: FIGURE 122.--Spring lancet, 19th century. (NMHT
1977.0576.01; SI photo 77-13961.)]
[Illustration: FIGURE 123.--Counter-irritation device. (NMHT 89797
[M-4305]; SI photo 72-11274.)]
[Illustration: FIGURE 124.--Barber surgeon's set, 18th century. (NMHT
199536 [M-6684-6692]; SI photo 73-4207.)]